Medicare Features Often Overlooked

Although Medicare is America’s largest payer for healthcare, participants are often unaware of the features and limitations of the program. It is a costly mistake to sign up for coverage, choose a supplement and drug plan and then never revisit the coverage. Want to save thousands? Here are some simple things to know about your coverage:

• Medicare does not cover medical care in a foreign country. Only Medigap plans C through G and M and N cover part of the cost of emergency care abroad during the first two months of a trip.

• You are paying too much for your prescriptions (probably). Choosing the right Part D prescription plan can save you thousands of dollars each year but a 2012 study showed that only 5.2% of beneficiaries picked the cheapest Part D coverage. And while you may have the least expensive policy this year, the coverage is rarely the least expensive two years in a row.

• Not all pharmacies charge the same price. Drug plans often offer “preferred retail cost sharing” to their members, meaning the pharmacy has contracted with the insurance company to provide lower-cost drugs than other pharmacies.

• You cannot buy a Medigap Policy to go with a Medicare Advantage plan. Medigap policies are only applicable when you are enrolled in Original Medicare.

• Cost of Medicare Part B goes up if your Modified Adjusted Gross Income is above $85,000 for a single and $170,000 for a couple. Your monthly premiums could be as much as $4,432 per year more for the same coverage!

Medicare Action Steps:

1. Purchase travel insurance before leaving the country. There are multiple companies that offer coverage that will provide you medically equipped transportation back to a hospital in your home country.

2. Go to to reprice your prescriptions each year. This handy tool allows you to input your regular prescriptions and compare plans to see which ones cover the prescriptions.

3. Shop the pharmacies with your coverage to ensure you receive the lowest price. Speak with the pharmacy to find out which insurance companies they have partnered with for lower costs or go directly to the insurance company to see if there is a pharmacy in your area they partner with.

4. Stop your Medigap policy while enrolled in a Medicare Advantage plan. If you’re switching from original Medicare to an Advantage plan, your Medigap policy becomes unusable. You have a short window to determine whether or not to keep your Advantage plan. If you decide you don’t like the Advantage plan, you can go back. However, if you keep the plan past the deadline, in most every case you cannot go back.

5. Manage your income to stay below the income thresholds. If your income falls below this threshold after paying the higher premiums, file a Medicare Income Life Changing Event form to reduce your payments.

6. Always review your coverage during annual open enrollment, from October 15th to December 7th. Don’t miss your opportunity to review your coverage. There may be some real savings to be found, but you won’t know unless you check.